Rabies (hydrophobia, hydrophobia)

Rabies (hydrophobia, hydrophobia) is an acute virus disease that occurs after the infected animal's saliva gets on the damaged skin. Characterized by the development of a kind of encephalitis with a fatal outcome.

Etiology, pathogenesis. The causative agent belongs to the group of rhabdoviruses. Pathogen for many warm-blooded animals that begin to secrete the virus with saliva 7-8 days before the onset of clinical symptoms. After the introduction through the damaged skin, the virus passes through the nerve trunks to the brain, causing swelling, hemorrhage, and degeneration of nerve cells. The virus also enters the salivary glands and is released into the external environment with saliva.

Symptoms, course. The incubation period lasts from 7 days to a year (usually 1-3 months). Identify the stages of harbingers, excitement and paralysis. The stage of harbingers lasts 1-3 days. At this time, the patient has unpleasant sensations in the area of ​​bite or oslubeniya (burning, drawing pain, itching), although the wound has already healed, unreasonable anxiety, depression, insomnia. The stage of excitation is characterized by hydrophobia, aerophobia and hypersensitivity. Hydrophobia (hydrophobia) is manifested in the fact that when you try to drink, and then only when you approach the lips of a glass of water, the patient has a convulsive contraction of the muscles of the pharynx and larynx, breathing becomes noisy in the form of short convulsions, a short-term respiratory arrest is possible. Seizures can arise from a blow in the face of a jet of air (aerophobia). Body temperature is subfebrile. Salivation is increased, the patient can not swallow saliva and constantly spits it. Excitation is increasing, visual and auditory hallucinations appear. Sometimes there are attacks of violence with aggressive actions. After 2-3 days, excitement is replaced by paralysis of the muscles of the limbs, tongue, face. Death occurs 12-20 hours after the appearance of paralysis. As variants of the flow, a bulbar form is distinguished with pronounced symptoms of the defeat of the medulla oblongata, paralytic (begins with paralysis, sometimes of the Landry type) and cerebellar with cerebellar disorders.

Differentiate from tetanus, encephalitis, encephalomyelitis, hysteria. After the death of patients, the diagnosis is confirmed by histological examination of the brain.

Treatment. After the appearance of clinical symptoms, patients can not be saved. Patients are placed in a darkened soundproofed room. Introduce again pantopone, aminazine, diphenhydramine, chloral hydrate in enemas.

Prevention. Fight rabies among animals and prevent rabies in people who have been bitten by infected animals. When you bite the wound is washed with soapy water, cauterized with tincture of iodine. Surgical excision of the edges of the wound and suturing in the early days are contraindicated. Anti-rabies vaccinations and seroterapy are carried out at Pasteur stations according to a special scheme approved by the Ministry of Health of the USSR.